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Invited Critique
Nov 2012

Publication of Postdischarge and Readmission Complications: Failure, Folly, or Funding Opportunity?Comment on “Association of Postdischarge Complications With Reoperation and Mortality in General Surgery”

Author Affiliations

Author Affiliation: Department of Surgery, Institute for Clinical Outcomes Research and Education, St Vincent's University Hospital, Dublin, Ireland.

Arch Surg. 2012;147(11):1007-1008. doi:10.1001/jamasurg.2013.496

Good surgeons know when to operate, who to treat conservatively, and how to minimize morbidity. Great surgeons manage complications expediently and well. Every surgeon will read the article by Kazaure et al1 with interest as complications are the statistics that define us all. They are increasingly used as quality metrics and will soon carry punitive remunerative consequences from health care insurers. More than one-third of complications arise after discharge and relate mainly to the general patient condition and the specific operative event (ie, classifiable but not remediable variables). There are glaring deficiencies in the risk factors presented such as smoking, body mass index, and serum albumin level.2,3 In publishing these data, they have been made more accessible to funding stakeholders. How can surgeons ensure they are interpreted in context?